Artikel
Interdisciplinary treatment of patients with unruptured intracranial aneurysms
Interdisziplinäre Behandlung von Patienten mit nichtrupturierten intrakraniellen Aneurysmen
Suche in Medline nach
Autoren
Veröffentlicht: | 30. Mai 2008 |
---|
Gliederung
Text
Objective: To review the treatment of unruptured intracranial aneurysms (UIA) using microsurgical clipping or endovascular coil obliteration in a single cerebrovascular centre in an interdisciplinary context regarding periprocedural complications and success of obliteration.
Methods: Data derived from a prospective database of intracranial aneurysms from June 1999 through February 2007 with all patients having a 3 months follow-up. Unfavorable outcome was classified as mRS greater than 2.
Results: Treatment was performed surgically on 165 UIA (126 patients) and endovascularly on 80 UIA (64 patients). There was no death related to any treatment in this series. After treatment the rate of new neurological deficits was 5% (4.8% of the patients with surgical and 5.4% of the patients with endovascular treatment). The outcome was good in 163 patients with surgical and patients with endovascular treatment UIA (124 and 73 patients, respectively) and only three patients (1.2%) had an unfavorable treatment-related outcome. Appropriate aneurysm obliteration was achieved in 97% of aneurysms using microsurgical and 90% using endovascular treatment. One patient with a complex basilar artery aneurysm suffered a SAH 14 months after endovascular treatment.
Conclusions: Even with complex UIA, the majority of patients can be successfully treated with excellent clinical results and a very low percentage of unfavorable outcome using microsurgical or endovascular aneurysm obliteration. If patients are carefully selected and individually assigned to their optimum treatment, the overall complication rate is low and outcome is independent of treatment modality.